Code of Conduct for pharmacists and other

persons registered
in terms of the Pharmacy Act

BN 108 of 24 October 2008

What is the Code of Conduct?

Governing the conduct of

Set the standard of professional conduct all persons (incl owners)

Sets out the fundamental duties

which apply to them Assist in achieving promoting public health

Provides more detailed

information regarding the Form the basis of a complaint
Act, rules and/or regulations
 Wellbeing of the
Use of trading patient
titles, brand Honour & dignity
names and logos of the patient

Dual registration Confidentiality

Chemical Continual
sold/provided in professional
a pharmacy development

Co‐operation
Control over with health care
medicines
professionals

Professional
appearance and Professional
independence
nature of the
pharmacy
Advertising
 WELLBEING OF THE PATIENT

Principle: ▪ Provision of medicine therapy should be to achieve appropriate

therapeutic outcomes that contribute towards patient health and
A pharmacist's prime concern in the quality of life i.e. benefiting the patient and the public as a whole
performance of his/her professional duties ▪ Ensure that when any medicinal product is sold or dispensed to the
must be for the wellbeing of both the patient, all the information on the package or container, which is
patient and other members of the necessary for the safe and effective use of the medicine is written in at
public. least one official language and that where available a patient
information leaflet is provided at the point of dispensing

▪ Ensure that the proposed user or purchaser of a medicinal product

receives advice on its safe use

▪ Must not give an impression to a potential purchaser that any product

or food supplement associated with the maintenance of or
enhancement of health is efficacious, when there is no evidence of
efficacy (SAHPRA)

▪ Must remain professionally competent and abreast of the latest

developments in the health area in which he/she functions in
accordance with his/her scope of practice
 HONOUR AND DIGNITY OF THE PROFESSION

Principle: ▪ Must have due regard for the reasonably accepted standards
of behaviour both within and outside his professional
A pharmacist must uphold the honour and practice
dignity of the profession and may not
engage in any activity which could bring
▪ Any breach of the law, whether or not directly related to a
pharmacist's professional practice, may be regarded as
the profession into disrepute bringing the profession into disrepute and may be
considered to be misconduct
▪ Must not use or permit the use of his/her qualifications or
his/her position as a pharmacist to mislead or defraud
▪ Ensure that a doctorate is not used in such a way as to lead
the public to believe that the pharmacist is a medical
practitioner
▪ Shall adhere to the standards and rules set out in the
Council's Rules as to Good Pharmacy Practice in South Africa
 CONFIDENTIALITY

Principle: ▪ A pharmacist must restrict access to information relating to a

patient to those who, in his/her professional judgment, need
A pharmacist must respect the that information in the interests of the patient or in the
confidentiality of information
public interest.
acquired in the course of
professional practice relating to a
patient and may not disclose such ▪ A pharmacist must ensure that anyone who has access to
information except under certain information relating to a patient—
prescribed circumstances – is aware of the need to respect its confidential nature;
– does not disclose such information without the written
consent of the patient.
The following are guidelines regarding circumstances when information might need to
be disclosed f a pharmacist judges it necessary
▪ to be shared with others who participate in, or assume responsibility for, the care or
treatment of the patient, and would be unable to provide that care or treatment without that
information (the need‐to‐know concept).
▪ to a person or body that is empowered by statute to require such a disclosure; for example,
in connection with a scheduled medicine or a notifiable disease.
▪ directed by the presiding officer of a court.
▪ for the purpose of a medical research project, which has been approved by a recognised

Assess the risks and serious

potential consequences
ethics committee
▪ to assist in the prevention, detection of or prosecution for serious crime or where
disclosure could prevent a serious risk to public health (public interest) –VERY RARE
▪ to prevent serious injury or damage to the health of a third party
▪ disclosure of the information requested might cause serious harm to the patient's physical
or mental health or well‐being, he/she may allow access to this information if the requester
can prove to his/her satisfaction that adequate provision is made for counselling or
arrangements as are reasonable before or during or after the disclosure of such information to
alleviate or avoid such harm to the patient.

THE CONTENT SHOULD BE LIMITEDTOTHE SPECIFIC MATTER INVOLVED

 CONFIDENTIALITY

▪ If the condition of the patient precludes the seeking of

Principle: his/her consent, for example, through unconsciousness,
mental handicap, psychiatric illness, dementia or brain injury,
A pharmacist must respect the the assessment in the best interests of the patient, should take
confidentiality of information into account any known wishes of the patient, the patient's
acquired in the course of next of kin, any other relative and anyone with power of
attorney
professional practice relating to
a patient and may not disclose ▪ Decide in the minor's best interests whether to release
information to a parent or guardian without the consent of
such information except under the minor
certain prescribed
circumstances ▪ Any disclosure and its extent should be recorded on the
patient's record

▪ None of the above precludes the collation of data from

patient records, on condition that it is presented
anonymously, for the purpose of research or as information
to an interested commercial source (patient and prescriber
names, addresses, telephone numbers and postal codes)
 CONTINUING PROFESSIONAL
DEVELOPMENT (CPD)

Responsibility of all pharmacists to—

Principle:
▪ keep abreast of changes in pharmacy practice;
A pharmacist must keep abreast
of the progress of professional ▪ remain up‐to‐date with the laws relating to pharmacy, the
knowledge in order to maintain a control of medicine and the knowledge and technology
high standard of competence
relative to his/her sphere of applicable to pharmacy; and
activity.
▪ maintain competence and effectiveness as a practitioner
 CO‐OPERATION WITH HEALTH CARE
PROFESSIONALS

▪ Maintain relationships
Principle:
▪ The health care team
The pharmacist must co‐operate with
other health care professionals to achieve ▪ Respect for other competencies
the best possible outcomes for the
patient. The pharmacist shall respect the ▪ Referrals
skills and competencies of other health ▪ Assist colleagues
care providers and endeavour to work
cooperatively with them to optimise the ▪ Not criticise colleagues
health outcomes of mutual patients and
the public.
 PROFFESSIONAL INDEPENDENCE

Principle: ▪ Should not agree to practise under terms or conditions that interfere
with or impair the proper exercise of professional judgment and skill,
A registered member of the profession that cause deterioration of the quality of professional services
should refrain from entering into, or rendered, or that require consent to unethical conduct.
being part of any transaction or ▪ May not collude with any person who is precluded in terms of
agreement, which may reflect the Regulations relating to the ownership and licensing of
negatively on his or her professional pharmacies from owning a pharmacy or have a beneficial interest
in a pharmacy.
independence or the professionalism,
or ethics of the profession as a whole. ▪ Professional co‐operation between pharmacist and medical
practitioner or other health care professional is to be welcomed, the
pharmacist—
– must ensure that patients have the freedom to choose where
they obtain their pharmaceutical services; and
– must, whenever possible, ensure that patients have given their
consent to their prescription being directed to a specific pharmacy
 Multi‐professional (group) practice principles

▪ professional accountability → ethical rules, policies, standards, codes of conduct and legislation
▪ professional independence
▪ professional responsibility assume responsibility only within their scope of professional competence and
accountability
▪ peer review and practice parameters to promote efficient, effective and safe practice
▪ equal norms and requirements — policies, ethical rules and codes of conduct must be applied consistently in all health care
delivery systems, including solo practices; Good Pharmacy Practice Manual and Associated SAPC rules
▪ client/patient/community interest — benefit of the patient →protected from potential exploitation
▪ freedom of referral
▪ shared resources subject to the principles of professional and ethical accountability, independence and
responsibility;

Pharmacy premises
▪ any place wherein or from which acts specially pertaining to the scope of practice of a pharmacist are performed, is
defined as a pharmacy in terms of the Pharmacy Act;
▪ all pharmacies must be properly licensed with the Department of Health and recorded with Council;
▪ conform with the rules relating to good pharmacy practice;
▪ under the control of a responsible pharmacist in terms of applicable legislation;
▪ pharmacy must be clearly demarcated
Perverse Incentives

▪ A patient must have the right to present it for dispensing at any pharmacy of his/her choice.
▪ A pharmacist must not approach a medical practitioner or medical practice staff to secure direction of prescriptions
to a particular pharmacy. A prescription should only be sent directly from a medical practice to a pharmacy when:
I. the patient has requested the direction; or
II. the patient is in residential care and has indicated his/her wish that the person providing that care may collect or receive
prescriptions on his/her behalf; or
III. the patient has an addiction problem and receives medication in defined, prearranged quantities.
▪ A pharmacist shall not offer or give inducements to any person in consideration of the supply to him/her of either
prescriptions or orders for medicines, devices or appliances for patients.
▪ A pharmacist, pharmacist intern or pharmacist's assistant may not engage in the following actions—

I. (advertise or endorse or encourage the use of any health establishment or medicine, complementary medicine, veterinary medicine,
medical device or scheduled substance or health related product or health related service in a manner that unfairly promotes the
practice of a particular health care professional or health care facility for the purpose of improper financial gain or other valuable
consideration;
II. engage in or advocate the preferential use of any health establishment or medical device or health related service or sell any
medicine, complementary medicine, veterinary medicine or scheduled substance, if any improper financial gain or other valuable
consideration is derived from such preferential use or prescription Good Pharmacy Practice Manual and Associated SAPC rules or
the advocacy of preferential use by the health care professional, unless entitled by law;
III. referral of clients or patients to any health establishment or to other health care professionals if such referral would constitute
IV. over servicing;
V. accept commission or any financial gain or other valuable consideration from any person(s) or body or service in return for the
purchase, sale or supply of any goods, substances or materials used by the health care professional in his or her practice;
VI. (v) pay commission or render any financial gain or other valuable consideration from any person(s) or body or service in
return for the purchase, sale or supply of any goods, substances or materials used by the health care professional in his or her practice;
VII. charge or receive a fee for services not personally rendered by the pharmacy.
Undesirable business practices
A pharmacist must not participate in any transactions or agreements, which runs counter to
the patient interest or clinical needs; and/or where patient or health practitioner choice is
limited and/or unduly influenced by the existence of such a transaction or agreement.
 ADVERTISING

▪ A pharmacist may make available information about himself/herself or his/her

practice, which is intended or may reasonably be regarded as being necessary for
the information of the public

▪ The distribution and content of publicity for professional services should be

Principle: dignified and restrained.

A pharmacist should, in the public ▪ Publicity covers all forms of announcements or information addressed to the
general public or health care professionals concerning the goods and services
interest, provide information offered by pharmacists or pharmacies.
about available services in or ▪ All forms of communication are covered and include, for example, editorial and
from a pharmacy complying with advertisements in print, electronic, radio and television media, as well as leaflets,
flyers, notices, signs, packaging material, labels, public address systems and
good pharmacy practice standards electronic mail.

and duly recorded in terms of the ▪ It is advisable to separate publicity for professional services from all other publicity.
PharmacyAct. Publicity must not ▪ Pharmacists may make known to the general public and erect remote direction
claim or imply any superiority signs indicating—
over the service provided by other –
–
location of the pharmacy;
trading title;
pharmacists or pharmacies, must – the address of the pharmacy;
be dignified and must not bring – telephone numbers;
– emergency services provided; and
the profession into disrepute. – the business hours of the pharmacy.
 ADVERTISING
Principle: ▪ Pharmacists may not advertise outside the pharmacy by way of flashing lights and/or
moving signs.
A pharmacist should, in the public
interest, provide information
about available services in or ▪ Medicines may only be advertised in or outside a pharmacy in accordance with regulation
from a pharmacy complying with 45 of the general regulations published in terms of the Medicines Act (GN R7636 of 10 April
good pharmacy practice standards 2003).
and duly recorded in terms of the
PharmacyAct. Publicity must not ▪ The advertising or promotion of medicines via the Internet must comply with regulation
claim or imply any superiority 45 of the general regulations published in terms of the Medicines Act and the rules relating
over the service provided by to good pharmacy practice.
other pharmacists or pharmacies,
must be dignified and must not ▪ A pharmacist may make known the names of medical schemes with which he/she has
bring the profession into contracted and/or to whose members he/she is prepared to provide pharmaceutical services.
disrepute.
▪ Publicity must not abuse the trust or exploit the lack of knowledge of a
consumer/patient.

▪ The responsible pharmacist must be responsible for the form and content of any publicity
whether placed by the responsible pharmacist personally, or by another staff member or
organisation on behalf of the pharmacy, and for any other publicity which the responsible
pharmacist expressly authorises. Where the responsible pharmacist becomes aware of any
impropriety in any publicity appearing on his/her behalf, he/she must forthwith use his/her
best endeavours to have the publicity rectified or withdrawn.
Publicity for
services
 Without limiting its generality 'touting or attempting to tout for Advertisements
prescriptions or business with regard to the sale of medicine' will include may contain:
the following—
 any unsolicited approach directly to a member of the public by way of a ▪ name, address,
telephone call, electronic means, or a visit made without prior appointment; telephone number and
trading hours of the
 any inducement by way of a gift, reward, rebate or participation in a competition pharmacy and other
in relation to professional services; branches;
 any publicity stating the specific charges for specific kinds of services to be ▪ arrangements made
undertaken by the pharmacy. However, the basis on which services rendered will be for emergency services
charged for may be publicised.
▪ titles 'chemist' and
 Information provided on services should be presented so as to allow the 'pharmacy’
recipient to make a decision, without being subjected to pressure. No
attempt should be made to solicit custom or to seek to influence the ▪ pharmacist's name and
patient's choice. qualifications
▪ location (map,
 Discreet information relating to services may be supplied to, and transport details and
displayed in a doctor's surgery, health care centre or local health care parking)
clinic. A pharmacist should not seek or agree to an arrangement giving
exclusive rights for the display of such ▪ services provided
according to
categories
PROFESSIONAL APPEARANCE AND NATURE OF PHARMACY

Principle: ▪ must ensure that it has sufficient facilities and equipment to

comply with all relevant regulations
A pharmacist offering services
directly to the public must do ▪ Reference to the provisions of the following act, rule or
so in or from pharmacy regulation applying to pharmacists can be made, but it is not an
premises that comply with exhaustive list with regard to the above:
good pharmacy practice
standards, which reflect the – Good Pharmacy Practice standards
professional character of [the]
pharmacy, and which is duly
recorded in terms of the
Pharmacy Act.
 CONTROL OVER MEDICINES

Principle: ▪ Professional responsibility to exercise control over all medicinal and related
products
A pharmacist must at all time
exercise proper and/or ▪ All pharmacists should keep abreast of current thinking, including legislation on
reasonable care in respect of safety and use of medicines and other products associated with maintenance or
and control over medicines. promotion of health
▪ Promptly action product recall
▪ Must not purchase where there is any reason to doubt its safety, quality or
efficacy.
▪ A pharmacist must be satisfied that both the supplier and the source of any
medicine purchased are licensed & recorded in terms of the Regulations
relating to the ownership and licensing of pharmacies, with the Pharmacy
Council. Due regard must be paid to the storage conditions before purchase
and to the labels, leaflets, appearance, origin and subsequent chain of supply of
the medicine concerned
▪ Medicines may only be sold/supplied to persons who are appropriately
authorised to be in possession of such medicines
Counterfeit and stolen medicines
a) Counterfeiting in relation to medicine includes the deliberate and fraudulent mislabelling with respect to the identity
and/or source of the medicine. A pharmacist must report to the Medicines Control Council or other competent authority any
instance where he/she suspects that he/she has been offered or has been supplied with counterfeit medicines. He/she must
isolate and withhold from sale or supply any such medicinal products.
b) A medicine registered with the Medicines Control Council must have the registration number on each pack. A pharmacist
must not accept medicinal products that are not so labelled.
c) The purchase, possession, sale, supply or dispensing of an unregistered medicinal product, except where specifically
permitted by legislation, is considered by Council to be unprofessional conduct, and subject to disciplinary action by
Council in terms of ChapterV of the Pharmacy Act.

Foil or blister packs

Medicinal products should not be accepted other than in their original outer packaging and should not be removed from a
manufacturer's blister or foil pack in order to create a bulk dispensing pack.They may, however, be removed at the time of
dispensing for an individual patient at the pharmacist's discretion to assist patient compliance.

Re‐use of medicines
A pharmacist should not re‐dispense a medicine, previously returned to the pharmacy by another patient, which had been in
that patient's possession
 Medicine misuse
▪ A pharmacist must exercise professional judgment to prevent the supply of unnecessary and excessive quantities of
medicines and other products, particularly those that are liable to be misused or abused.
▪ Many scheduled medicines have a potential for misuse or dependency. Care should be taken with their supply even
when it is legally authorised by prescription or signed order. A pharmacist should be alert to the possibility of medicine
dependency in health care professionals and patients, should make enquiries to ensure that such medicines are to be
used responsibly and should refuse to dispense these medicines when circumstances warrant such refusal.
▪ Certain non‐prescription medicines and non‐medicinal products are likely to be misused/abused, which in this
context usually means—
– consumption over a lengthy period; and/or
– consumption of doses substantially higher than recommended.
▪ Requests for such products should be dealt with personally by the pharmacist and sale should be refused if it is
apparent that the purchase is not for a genuine medicinal purpose or if the frequency of purchase suggests overuse.
▪ When a pharmacist becomes aware that a patient is abusing a substance, that patient should be referred to an
appropriate practitioner or institution.
▪ The products which are abused are subject to change and pharmacists should keep abreast of local and national
trends.

Medicines used to reduce intoxication

A pharmacist must not purchase, supply or advise a person to buy any preparation, whether classified as a medicine or
not, which is claimed to mask the signs of intoxication, which indicate unfitness to drive a vehicle or operate heavy
equipment which can present a hazard to the public, by accelerating the removal of alcohol from the body or
otherwise
Indirect supply of medicine (mail
order/courier pharmaceutical service)
Although it is preferable for a pharmacist to give medicines directly to the patient /caregiver, when it is
necessary to sell, supply or deliver medicine or scheduled substances by or through the mail/courier to a
patient or to members of the public or to a person who receives medicine on behalf of the patient, the
pharmacist must ensure that—
(a) the medicine is packaged in such a manner that it will guarantee the safety, quality and efficacy of medicines in
accordance with the registration requirements for such medicine in terms of the Medicines Act, throughout the
delivery process;
(b) a control system is implemented that will enable the pharmacist to detect and correct a delay in the delivery
process;
(c) a report back system is introduced to ensure that problems with medicine distribution and delivery are detected
timeously;
(d) where available a patient information leaflet is provided
(e) medicines which are prescribed for acute ailments or conditions (i.e. immediate need, not repeatable and
non‐chronic conditions) shall not be delivered to patients by mail/courier;
(f) medicines that are registered to be stored in conditions under 8ºC shall not be delivered to patients by
mail/courier unless cold chain management is ensure
Emergency supply of medicine or scheduled substance
A pharmacist must do everything reasonably possible to assist a person in need of emergency medical treatment or
emergency supply of medicines in accordance with section 22A of the Medicines and Related Substances Act.
Reference to the provisions of the following act, rule or regulation applying to pharmacists can be made, but it is not
an exhaustive list with regard to the above:
• Sections 22A and 22C(1)(b) of the Medicines and Related Substances Act 101 of 1965
 CHEMICALS SOLD/PROVIDED IN A PHARMACY

Principle: ▪ Reasonable care should be taken by the pharmacist when supplying chemicals which may
be used for the preparation of explosives or fireworks e.g.: chlorates, nitrates,
A pharmacist must take steps magnesium, potassium permanganate (especially with glycerine/glycerol), sulphur,
to ensure that all chemicals powdered aluminium, phosphorus and any oxidising or reducing agent, that such
supplied will be used for a chemicals are not used for these purposes. Such chemicals, including solvents, should
not be sold to a person under 14 years of age.
proper purpose and in
appropriate circumstances. ▪ Pharmacists should take reasonable steps to ensure that chemicals bought for use in a
child's chemistry set will be used under the supervision of an adult. A pharmacist should
take reasonable steps to be satisfied that the purchaser of chemicals, including solvents,
for industrial purposes or for a hobby, has sufficient knowledge to handle the chemicals
safely and will use the chemicals for a proper purpose. A pharmacist should be aware of
the requirements of all relevant legislation relating to occupational health and safety,
hazardous substances and the abuse of dependence producing substances.
 DUAL REGISTRATION

Principle: ▪ In adhering to this principle the pharmacist who holds registration with
more than one statutory health council shall at all times ensure that—
The registration with more – no conflict of interest arises from such dual registration in the
than one statutory health rendering of health services to patients;
council would be permissible – patients are clearly informed at the start of the consultation of
provided that the pharmacist the status of the pharmacist, i.e. in which capacity the pharmacist
should at all times comply will be acting and the informed consent of the patient thereto is
obtained in writing;
with the ethical rules of each – patients are not consulted in a dual capacity or charged fees
of the professions registered based on such dual consultation;
with the respective Council. – the ethical rules applicable at a given moment to the profession in
which he or she is acting, are strictly adhered to.
 THE USE OF TRADING TITLES, BRAND NAMES AND
LOGOS

Principle: ▪ No person issued with a licence in terms of section 22 of the Act

and no pharmacy shall adopt and use a trading title, brand
A pharmacist and/or name or logo for a retail pharmacy or an institutional pharmacy
registered pharmacy owner without the prior written approval of the Council.
must ensure that all trading ▪ In deciding whether the trading title, brand name or logo
titles, brand names and (collectively referred to as 'the name') is acceptable to the Council, the
logos, are approved and following will be taken into account—
recorded with Council. – duplication of names, i.e. whether such name is being used by
another person or entity;
– the Council shall not approve names that are calculated to suggest
that the pharmacy in question is superior to other pharmacies;
– offensive names will not be approved;
– names will not be approved which create the impression that
medicines are being sold at discount;
– names which may cause the public to be misled, will not be
approved;
– if a name can lead to passing off, same will not be approved;
– the Council shall not approve names that are not associated with or
do not belong to the pharmacy concerned.